Causes of Infertility in
Men and Women
By: Tammy, Merissa, and Heather
For Nursing 519 Unit 6
Infertility…an overview
 Infertility
is defined as the inability
to conceive after 1 year of
unprotected sex.
 Infertility affects approximately
15% of couples (McCance
&Huether, 2006).
Infertility in Men


Male factors influencing infertility include
decreased production and quality of sperm as
well as impaired delivery of sperm (McCance &
Huether, 2006).
Decreased production and quality of sperm
include the following factors: Impaired shape
and movement of sperm, low sperm counts,
varicocele, or infection (Mayoclinic.com, 2007).


In men, hyperthyroidism can decrease
production and motility of sperm, in
comparison to women, where hypothyroidism
can decrease fertility (McCance & Huether,
2006).
Impaired delivery of sperm may include the
following factors: Blockage of the epididymis or
ejaculatory ducts, hydrospadias, or anti-sperm
antibodies (Mayoclinic.com, 2007).


Health and lifestyle factors such as stress, drug
or alcohol abuse, and a history of radiation to
the testicles impact male
fertility (Mayoclinic.com, 2007).
In addition, a history of STDs, smoking, and
chemical exposure are other factors that may
impact male fertility (McCance & Huether,
2006).
Infertility in Women


Common Causes of Infertility in Women
Retrieved from Fertility.com
Retrieved from Fertility.com
Polycystic Ovarian Disease (PCOD)
 In
POD, ovaries become enlarged.
They have a smoother and thicker
layer than nondiseased ovaries. They
are covered with small cysts, which
may cause amenorrhea or infrequent
menstrual cycles (Cooper, 2007).
POD can be classified into three
categories:
 Mild – women with mild POD may take
longer to conceive, but can conceive
nevertheless. They have normal ovulation.
There is an increased incidence of
spontaneous miscarriage associated with
Mild POD.

Moderate – These women do not ovulate
or have infrequent cycles. They will have
amenorrhea.
 Severe – No menses present. Women are
infertile. These women are usually obese
and display hirsutism (facial hair) (Cooper,
2007).



An over production of luteinizing hormone by
the pituitary gland causes abnormally high levels
of androgens in the body, specifically
testosterone.
According to Wikipedia.com, “a majority of
patients with PCOS have insulin resistance
and/or are obese. Their elevated insulin levels
contribute to or cause the abnormalities seen in
the hypothalamic-pituitary-ovarian axis that lead
to PCOS” (2009).
Endometriosis

Endometriosis occurs when the endometrium
proliferates, spreading into the pelvis. Infertility
occurs when it implants onto the pelvic floor
causing obstruction with adhesions. It may
cause damage to the fallopian tubes and ovaries.
Women with this disorder may have very
painful, heavy and long menses. Interestingly,
the amount of symptoms present is not
reflective of the degree of disease present
(Cooper, 2007).

The exact cause of endometriosis is
unknown. It is hypothesized that several
etiologies could lead to the disease
including increased estrogen levels,
retrograde menstruation, lymphatic or
vascular distribution, immune system
dysfunctions and genetic factors
(endometriosis.org, 2007).
Pelvic Inflammatory Disease (PID)
 PID
is usually caused by sexually
transmitted diseases like Chlamydia
and Gonorrhea. PID is the main
cause of tubal infertility because
mucus is altered in the tubes and
adhesions and obstructions are formed
(Cooper, 2007).
A question to ponder…

What role can NPs play in assisting couples
experiencing infertility?
References




Cooper, M. (2007). Female infertility: pathophysiology.
Practice Nursing, (18)12. 611-614.
Denson, V. (2006). Diagnosis and management of
infertility. American College of Nurse Practitioners, (2)6. 380386
Endometriosis.com (2007). What causes endometriosis?
Retrieved February 10, 2009, from
http://www.endometriosis.org/causes.html
Fertility.com (2008). PCOD: Polycystic ovary disease.
Retrieved February 10, 2009, from
http://www.fertility.com/international/concern/Inferti
lity_in_Females/Ovulatory/Polycystic_Ovary_Disease.j
sp
References continued



Mayoclinic.com (2007). Infertility. Retrieved February
9, 2009 from
http://www.mayoclinic.com/health/infertility/DS0031
0/DSECTION=causes
McCance, K., & Huether, S. (2006). Pathophysiology:
The biologic basis for disease in adults and children.
(5th ed.). St. Louis, MI: Elsevier Mosby.
Wikipedia. (2009, February). Polycystic ovary
syndrome. Retrieved February 10, 2009, from
http://en.wikipedia.org/wiki/Polycystic_ovary_syndro
me#Pathogenesis